Louisiana’s Cassidy in damage-control mode

Rep. Bill Cassidy (R-La.) found himself in a bit of trouble this week when a recording surfaced, showing the congressman describing Americans lacking health insurance as “less sophisticated,” “less comfortable with forms,” and “less educated.” Cassidy, a leading U.S. Senate candidate this year, added that the uninsured are often “illiterate.”

Given the number of uninsured Louisianans, many of whom were likely to be unimpressed with Cassidy’s dismissive, elitist attitude, the Republican scrambled yesterday to put things right.

In a statement Thursday, Cassidy, who as a physician has and continues to treat uninsured patients, discussed what he was trying to say.

“As a doctor, I can tell you that you need an honest diagnosis before you can provide the needed treatment,” Cassidy said. “It is self-evident to anyone who has worked with the uninsured, as I have for decades, that the uninsured come from all segments of society. This includes the more and the less educated. That’s exactly the point I made and make: if we seek to be truly compassionate, our policies must meet people where they are. Obamacare’s one-size-fits-all model lacks this basic measure of compassion.”

That’s not a bad spin, I suppose, though it’s hardly a persuasive response to the controversy.

For one thing, what he said in his written statement is in no way similar to what he said last week at the Louisiana Oil and Gas Association’s annual meeting. Yesterday’s statement reads less like a clarification and more like an attempted reversal.

For another, if Cassidy appreciates the importance of “honest diagnoses,” he might want to acknowledge that his disparagement of the uninsured was factually dubious.

But even if we put that aside, why in the world would a federal lawmaker and U.S. Senate candidate see the Affordable Care Act as a “one-size-fits-all model”?

Under the current system, with the ACA in place, most Americans will receive private insurance through the employer. Millions more will be covered through Medicare. Some will have coverage through S-CHIP, some through the V.A., some through Medicaid. Millions more will get private insurance through exchange marketplaces, run through either a federal or state system, while others will get similar coverage while bypassing the exchanges.

Those who do enroll through exchanges can choose between competing plans and different levels of coverage, and might be eligible for subsidies based on income.

This is the very definition of a patch-work system. If Bill Cassidy sees this as a “one-size-fits-all model,” he’s using a phrase he simply doesn’t understand.